Jac, as this paper showcases, upwards of 50% of people with a vitamin B12 of between 200 and 400 pg/ml are in fact deficient. I my opinion, anyone with Crohn's disease should work to get their B12 level above 500 pg/ml.

I get B12 shots and my B12 was just over 300. After a shot its over 2,000. Just before a shot its back down in the 300's. I get them every other month but may be switching back to once month. Had a bad doctor in the past who made it every other month instead of once a month because he said my B12 was high, well duh, you had it tested right after I got the shot, you need to test right before your next shot. So yes jac521, B12 shots can be given if you're below 400. I think every doctor has their own "normal" range but 210 is pretty low.

I was on B12 tabs between diagnosis period and confirmation of crohns. Once the meds were sorted out, I was gradually taken off them and never needed them since. Had to go on iron tabs a few times since for short periods, but B12 has never dropped. Levels were checked recently and all was ok.

I took supplements for a short while, but gave up as everything was going well.

David - I have been taking B12 injections from my regular MD (cyanocobalamin). I honestly didn't notice a significant difference. I took them for 3 months and tested and went from a 34 to a 32. I started seeing a Naturopath to discuss Vitamins and Supps and in discussion she mentions that cynocolalamin is not the best one to use. When I asked the MD he would not prescribe anything else. My GI doesn't suggest any sort of vitamin injections at all. He says use pills or drops. All that to ask - does anyone else use a different type? Found one better than the other?

Cyanocobalamin
Cyanocobalamin is the most commonly injected form of B12 in the U.S. and is used to treat all forms of vitamin B12 deficiency and pernicious anemia. The popularity of cyanocobalamin is due to the hardy structure of the molecule, making it more durable and resistance to air-damage. However, this form of B12 does not occur on its own in the natural world and when ingested provides small doses of cyanide. Once in the human body, the small cyanide portion of the B12 molecule will be lost and passed out of the human body and cyanocobalamin becomes methylcobalamin. Smokers are less able to transform cyanocobalamin into methylcobalamin due to toxins and heavy metals in the liver, making this form of B12 not bioavailable to a large number of the population.

Hydroxocobalamin
Hydroxocobalamin is one of the natural forms of vitamin B12 that is produced by bacteria and can be sterilized for injection. When compared to cyanocobalamin, this form of B12 is retained for longer periods in the body and so it reduces the need for frequent injection. Hydroxocobalamin can also be used to treat cyanide poisoning as it will attach to any cyanide molecules that it comes into contact with. Once hydroxocobalamin attaches to cyanide circulating in the blood, it becomes cyanocobalamin. In this form, the cyanide is harmlessly passed through the urine and out of the body.

Methylcobalamin
Methylcobalamin is another natural form of B12 and is one of the active forms of the vitamin that occurs within the human body. The cyanide portion of the B12 molecule has been replaced with a methyl group and is more bioavailable to smokers who cannot transform cyanocobalamin into methylcobalamin in the liver. Methylcobalamin has been studied for the treatment of some sleep disorders. In a study published in "Psychiatry and Clinical Neuroscience" in 1999, researchers found methylcobalamin produced some limited benefit to patients suffering from sleep-wake rhythm disorders.

Adenosylcobalamin
Adenosylcobalamin is another active form of vitamin B12 that is found in the human body and can either be supplemented orally or through injection. According to Michael Murray, N.D., author of "Encyclopedia of Natural Medicine," adenosylcobalamin has been supported by research to be more effective than cyanocobalamin in prolonging the life of mice suffering from liver cancer.

(NaturalNews) Once someone has overcome all of the hurdles to get appropriate testing and is told that they have vitamin B12 deficiency, there is still a problem to overcome- getting the right KIND of vitamin B12. There are several kinds of vitamin B12 that are all CALLED vitamin B12, but only ONE, methylcobalamin, is the form that should be used in the vast majority of cases. Yet few doctors use methylcobalamin, favoring using their prescription pads and tradition over good science in their decision to supplement this vital vitamin.

When talking about vitamin B12, this is actually a generic term for a class of compounds called the Cobalamins, and indeed when one has vitamin B12 deficiency, it is more scientifically called Cobalamin Deficiency. This makes perfect sense when you understand that the various formulations of Vitamin B12 all end with the suffix Cobalamin. While there are MANY `Cobalamins`, only three are generally used as dietary supplements, namely:

Hydroxocobalamin
Cyanocobalamin
Methylcobalamin

All three types are considered `Vitamin B12`, they are NOT all the same and using the right one can be a critical decision. Cyanocobalamin is probably the most commonly used in the medical world and is often given as `B12 Shots` in a doctor's office for those with certain medical conditions. But cyanocobalamin is actually the WORST choice, despite the fact that doctors in the US are more likely to prescribe it over any other form. Not only does cyanocobalamin require a higher dosage for the same effectiveness of hydroxycobalamin, but it is Entirely Ineffective for several different conditions related to vitamin B12 deficiency. As such, it has been suggested repeatedly by several researchers, starting with Dr. AG Freeman in 1970, that cyanocobalamin should be removed from the market. While Great Britain followed through with researcher recommendations and removed the inferior product, doctors in the the United States have no such restrictions and still use cyanocobalamin routinely.

"...there [is] no condition in which it has been
claimed that cyanocobalamin was
preferable to hydroxocobalamin"
`Cyanocobalamin- a case for withdrawal: discussion paper`

While hydroxocobalamin is preferred over cyanocobalamin, another formulation called methylcobalamin is actually the BEST choice. Technically a `coenzyme` of vitamin B12, it is almost never used despite being effective, readily available, inexpensive and available in both sublingual preparations and injectable form. This is too bad because there are many people that could very well benefit from the methylcobalamin form of vitamin B12 that would NOT benefit from the other forms. Degenerative neurologic problems are where methylcobalamin shows its greatest benefits over other cobalamin preparations, and it is often one of the ONLY promising treatments for these tragic diseases. While Japan uses methylcobalamin nearly exclusively and it is the form present in prescription vitamin B12 there, the United States has virtually ignored the hundreds of studies that show the benefits this simple vitamin can bring.

"Methylcobalamin is the form found in food and
has much higher bioavailability than the form most
widely available in supplements, cyanocobalamin."
`B12 (Cobalamin)`

Not only has methylcobalamin been shown to work in neurologic diseases, it also helps with the elimination of toxic substances in the body. One of the ways that humans detoxify is through a process called 'Methylation'. Methylation is a CRITICAL function of a healthy body, but all too often we 'use up' the necessary raw materials because of our nearly constant exposure to environmental pollutants. Methylcobalamin is actually able to replenish the 'methyl' portion that is missing in methylation, while the other forms of vitamin B12 REQUIRE a methyl donor in order to be converted into a biologically active form in the blood. Therefore, people who already HAVE methylation detoxification problems, such as children with autism, can actually be made WORSE if other forms of vitamin B12 are administered!

While getting ENOUGH vitamin B12 is an important factor for maintaining general well being, getting the right KIND, in the form of methylcobalin is equally important. In fact, choosing correctly could very well mean the difference between good health and disease.

J not diagnosed with crohns but her levels in October were 143 and latest not able to be tested because less than 100 days!!. Had severe pins and needles shooting up her back, on her face, arms and legs. The ONLY reason why this was checked is because you guys on here suggested it, not her nurse or her GI!!!

THANK YOU GUYS!! it is one less thing she is suffering with at the moment (just finished B12 loading dose)

Laura, are you sure that your serum vitamin B12 level came back at 34 and 32 pg/ml? Because if so, those levels are critically low and you should be getting injections every couple days until it gets MUCH higher.

I know they don't prescribe cyanocobalamin in the UK but that's what we get here in the USA. It seems that methylcobalamin is superior but I really don't enough about it to say so with certainty. All the natural health type sites seem to prefer methylcobalamin though.

David,
I had read that too, mine is 307. VIT D was 18. When I spoke to my Dr he wasn't bothered
by that number. On the other hand my GP is freaked out by the 50,000 (unt?) of Vit D I am on per day. To be honest I am very overwhelmed the last few weeks with all these CD issues I have.

Lauren

__________________

Diagnosed= 1992 and again Feb 2012 Confirmed with
CT enterography May 2015 !!

Waiting for the ok from my Ins company to restart Remicade. Will also start Imuron to get into remission!
I know it's out there somewhere and I WILL find it!

DX Crohn's July , now IBS and adhesions. Anyway, my B12 was the lowest they said they have seen. I swear it was 80 but that can't be right, right. I give myself B12 Injections every week. 80? I swear that was the # but? Asking my Dr.

David - I just bought a multiple B complex in a liquid form today. It says on the bottle that it has 1.2 mg of B12 per 1 mL(cc). Do you know if that is a good dose?

What dose do they recommend?

Oral formulations of B12 may or may not help. In my opinion, you want to get your B12 above 500 ng/ml. If you're able to do this with an oral formulation, great. But many people with Crohn's cannot. As such, if you want to try the oral form, go for it. But get your B12 retested in say 3-6 weeks and see what your level is. If it's still really low, you may need injections.